<?php

	
			echo "
				<form action='solicitudponer.php' method='POST'>
					<div id='titulo'> &iquest QUE ME PONGO ? </div>
					
					<div id='contenedor13'>Tipo: </div>
					<div id='contenedor15'>
						<select name='tipo'>
							<option value=''>Ninguno</option>
							<option value='Bragapanal'>Bragapanal</option>
							<option value='Slip'>Slip</option>
							<option value='Boxer'>Boxer</option>
							<option value='Flex'>Flex</option>
							<option value='Compresa'>Compresa</option>
						</select>
					</div>
					
					<div id='contenedor13'>Dia/Noche: </div>
					<div id='contenedor15'>
						<select name='dino'>
							<option value=''>Ninguno</option>
							<option value='Dia'>Dia</option>
							<option value='Noche'>Noche</option>
							<option value='Indistinto'>Indistinto</option>
						</select>
					</div>
					<input type='submit' name='poner' value='Solicitar' style='width:100px; height:30px'>
				</form>
			
			";
		
		




?>